Cholesterol has a very important function in our body: it is essential for the normal development of the brain and for the synthesis of certain hormones and is a precursor of vitamin D. In short, cholesterol itself is an ally. It only becomes an enemy when it is found in excess in our body. And there are two types of cholesterol, the 'good' (formally known as HDL cholesterol), and the bad (known as LDL).

Having high 'bad' cholesterol is one of the main risk factors for suffering a myocardial infarction because, in excess, LDL cholesterol tends to be deposited in the wall of the arteries, causing their progressive thickening and hardening, that is, atherosclerosis. If nothing is done about it, over time true plaques can form that obstruct blood flow and can even block it. In addition, the plaques can break off and form a thrombus (clot), which in turn can lead to a myocardial infarction or stroke.

HDL cholesterol, on the other hand, is "good" because it cleans the floor of the arteries by sweeping away the "grease spots", so it has a protective effect against cardiovascular diseases.

The "correct" values differ from person to person depending on age and risk factors, but generally the recommendation is that total cholesterol is less than 200 mg / dl, 'bad' cholesterol, less than 116 mg / dl, and 'good' cholesterol, is between 40 and 70 mg / dl.

Diet influences cholesterol production

In case of excess, before taking supplements or drugs to reduce cholesterol levels, it is usually effective and sufficient to intervene with a dietary-behavioral approach. "It is true that most of the cholesterol (about 80%) is what we produce due to our personal genetic profile," explains Ilaria Prandoni, biologist and nutritionist at Palazzo della Salute of the San Donato Group, "but it has been seen that the daily quota of ingested cholesterol also modifies the genetic levels of production."

"The Mediterranean diet is already low in cholesterol, but above all low in saturated fatty acids and sugar," recalls the specialist, "and therefore ideal for keeping cholesterol within limits."

For years, the focus has been on individual foods and the amount of cholesterol they contain. For some time now, however, the "calculation" has been done in a slightly different way: "In recent years, scientific research has proven that it is not so much dietary cholesterol that increases the amount of cholesterol in the bloodstream, but above all saturated fatty acids and the choice of carbohydrates we eat. So the first rule is: "little sugar and, above all, whole grains".

Foods that lower LDL cholesterol

The most important role is played by fibers: "They reduce the intestinal absorption of saturated fatty acids and dietary cholesterol (as well as sugars)," says the nutritionist. "We give the green light, therefore, to fruits, vegetables, whole grains and legumes. Vegetables and fruit should be present every day at least in the two main meals and then also as a healthy snack. Whole grains should be consumed at least twice a day. Barley and oats, in particular, contain beta-glucans that lower bad cholesterol."

If the main responsible for excess 'bad' cholesterol in the body are saturated fats and sugars, it is easy to draw up a list of food categories to avoid: "These are foods of animal origin (butter and butter), processed meats and sausages, packaged products (such as snacks, cookies, spreads and some oils) because they may contain fatty acids that are called trans fatty acids and are really harmful to health. Trans fatty acids can be found in some industrial products due to the production process, although the European Union has put in place regulations to limit and eliminate the presence of these fats," he explains.

Designated foods

Some specific foods deserve special attention. like eggs." Eggs are a food with an excellent nutritional profile, but as a single egg provides about 200 mg of cholesterol (and it is advisable to stay below 300 mg a day)," he says. Therefore, this food has always been 'under the magnifying glass'. "However, recent studies have shown that there is no direct correlation between egg consumption and increased cardiovascular risk, to the point that international bodies no longer impose a limit on egg consumption. Two to four a week is fine," he says.

Another food that has always been marked is cheese. "Cheeses contain a lot of fats, especially saturated, in fact in this case the advice is always to limit them to 2-3 times a week and preferably choose low-fat cheeses," says Prandoni. Something similar happens with milk, which should be consumed skimmed or semi-skimmed.

But what are the best options for a main course? "Favor fish (especially small fish such as sardines, anchovies, mackerel for its Omega 3 content) that should be consumed at least three times a week with a quick and gentle cooking," says Prandoni. Legumes are also good: they are a source of fiber and compounds called phytosterols that compete with the intestinal absorption of cholesterol, so it is recommended to consume them at least 3 times a week. "Meats are not prohibited, but lean whites, devoid of fat, are better," and as a condiment, adds the doctor, "cold-pressed vegetable oils (seeds and olives) are preferable, and nuts are excellent as a snack between main meals."

In any case, it is the doctor who. After analyzing the blood tests, you should give the first advice regarding personal and family risk factors, and also decide when to start checks to monitor cholesterol levels. It is not uncommon, in fact, to find hypercholesterolemia even in children and adolescents, since the cause is always a mixture of genetics and lifestyle. "Excess cholesterol, in fact, is not an element that depends on age or aging, with the exception of menopausal women, who after 50 years tend to present in general an increase in LDL cholesterol and a reduction in HDL," concludes the specialist.

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